Friday, November 7, 2014

The Seventh Stage

I'm sure I mentioned in my second last post that Mum has definitely entered the 7th stage of Alzheimers Disease. 

She's become incontinent and usually can't put together a sentence that makes sense. In the past few months, she's lost the ability to write on a greeting card. Before that, her handwriting and spelling were excellent, which was very surprising for someone in the 6th stage. 

The staff at the nursing home had asked me to take her to a psychiatrist specializing in geriatric care because she had been grabbing other patients and dragging them up and down the hallway. For years she has been walking compulsively back and forth. The other patients weren't up to walking and were in danger of falling. When staff would try and stop her grabbing them by the arms and walkers, she would try to hit them, or tell the other patient to hit the staff members. 

But I have visited her at different times of the day the past three weeks and she's always been either sitting in a chair asleep or in her bed asleep. It seems the obsessive walking stage is over. I'm glad. I have never trusted psychiatry. On the other hand she shouldn't have to suffer so I don't mind her having the anti-psychotic that she's taking to try and settle her a bit. 

A lot of things have changed in the past couple of months. I no longer have trouble leaving her - she doesn't recall that I was ever there, within seconds of my being out of sight. Three months ago, when I would try and leave, she would grab me and plead with me not to leave her there, which made me feel terrible. But now, I just go. I don't say goodbye as I don't want to upset her; I just walk far enough away that she can no longer see me and I see that she's happy enough to just doze off. 

She doesn't ask to go to my house to see the dog and the cats. I don't think she remembers them any more. Last time she saw my dog, she was convinced he was a cat. 
I wrote about that two posts back. I've said a few of these things before but I just feel the need to go over it again. 

I notice she is having trouble swallowing solid food. She chews and chews and can't swallow. She really doesn't want to eat any more. There is no pleasure in eating these days, or even in having a cup of tea.

I don't think there is anything that makes her happy. For years she hasn't been able to stand having music on in her room. I took the TV away over a year ago because she'd just keep saying, "Turn off that horrible noise." She couldn't follow anything on TV, and that has been the case for about four years.

It's a terrible shame about music. She played 1st Violin and piano. She loved classical music and all types really. She was a ballroom dancing teacher. Now she can't stand to hear music. I suppose she hears it differently now. You know if you smoke marijuana, it does something to your ears-brain connection and you hear the music in a different way. Well, I guess due to the altered state of her brain, she hears the music in a nasty, cacophonous way. 

It's just terrible when there's nothing you can do to make someone happy. You can't chat to them; they don't want to hear it. You can't give them a cup of tea; it's just stressful trying to hold it and remembering to drink it. You can't turn on the TV or the radio. If you take them for a drive, they keep saying they're in pain: my back hurts, my stomach hurts, I feel sick. Take me home. If you take them outside in the sun, they feel cold, no matter how warm it is. Take me back inside - I can't stand this. It's cold. It's windy. It's horrible. In fact, it's a beautiful sunny day and 27C or around 80F.

I do have to start thinking of end of life issues. Perhaps the end is in sight; or perhaps the horror will continue another two or three years; who knows. But just in case, I am thinking about it.

She's not eating much so she shouldn't be forced to eat, but she should be offered drinks at every opportunity. If she refuses, it is her choice. I would never allow tube feeding, though if she were unconscious, I'd allow a drip so she'd be comfortable and hydrated.

She has had a few falls and is wearing hip and leg protectors. That's OK but I hope the staff don't worry too much that she'll fall. It's nature taking its course, I believe. She should be allowed to get up and walk if that's what she wants to do. She should be allowed to sleep in the daytime if she wants to, and she often does. I'm glad they don't try to make her stay awake. 

If you compare these three photos you can see the difference. The first is from a few months ago when she was still able to enjoy visiting me and the animals, drinking tea and eating cake. The second is from last month when the nursing home had a Roaring Twenties Ball. The third was taken yesterday. You can see the extreme stress and fear in her face. It's just terrible to see.



Happy on the veranda with Ned and two cats six months ago


Trying hard to enjoy herself at the Roaring Twenties Ball three weeks back.


And this week.